Occupational therapists’ experiences of intra-professional collaboration during the discharge process from inpatient care to home healthcare

Abstract

Introduction Swedish healthcare has undergone significant changes since the transferral of home healthcare from a regional to municipal responsibility, and since the new 2018 law regulating discharge from hospital. This meant changes to ways of working for Occupational Therapists (OTs), as OTs play a key role in planning for discharging patients, a crucial process before patients return home, and in the transition between care givers. Aim The aim of this study is to illuminate how OTs experience the intra-professional collaboration during the discharge process between inpatient care and home healthcare. Methods Interviews were conducted with OTs (N = 12), with even distribution between inpatient care and home healthcare, in three geographical locations in Sweden. Data analysis was performed according to qualitative content analysis. Results A central theme ran through all categories; the multi faces of intra-professional communication are challenging, intertwined and emotional. The categories illuminate experiences in terms of important but neglected patient participation and safety, different forms of mind-set depending on setting, complex rapid communication, unpredictable paths of discharge, unclear responsibility and organisational guidelines and, impact on work health and OT emotions. Conclusion Intra-professional communication is complex with many aspects and perspectives of importance for collaboration to run smoothly, but also the many individuals involved in the collaboration process of discharging a patient. This situates high demands on the professionals involved to distinguish and identify necessary information to make the discharge sound and safe for patient, as well as for relatives, involved services, and manageable for OTs.